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先天性肺气道畸形容积比对先天性肺畸形胎儿水肿的诊断价值:系统评价和荟萃分析。

Diagnostic value of congenital pulmonary airway malformation volume ratio for fetal hydrops due to congenital lung malformations: a systematic review and meta-analysis.

机构信息

Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China.

Department of Pediatric Surgery, West China Hospitial, Sichuan University, Sichuan, China.

出版信息

Orphanet J Rare Dis. 2022 Jun 3;17(1):213. doi: 10.1186/s13023-022-02347-0.

Abstract

OBJECTIVE

Meta-analysis was used to evaluate the diagnostic value of a CVR cut-off value of 1.6 for fetal hydrops due to congenital lung malformation (CLM).

METHODS

A systematic search of PubMed, Embase, Web of Science, CNKI, VIP, and Wanfang published before 7/30/2021 for the value of a congenital pulmonary airway malformation volume ratio (CVR) cut-off value of 1.6 for the diagnosis of fetal hydrops. According to the inclusion and exclusion criteria, the literature that met the requirements were obtained. A total of 75 articles were retrieved, and 12 articles were included for further analysis. The quality of these studies was evaluated according to the Quality Assessment for Studies of Diagnostic Accuracy tool (QUADAS-2) criteria. The Q test and heterogeneity I were used to evaluate the heterogeneity due to non-threshold effects, and Stata 15.0 was used for statistical analysis to evaluate the diagnostic value of the CVR cutoff value of 1.6 for fetal hydrops due to CLM.

RESULTS

A total of 12 studies were included. The QUADAS-2 indicated that the risk of bias was relatively low, and the clinical applicability was relatively high. Statistical analysis was performed on included studies using a random effect model. Meta-analysis showed that the pooled sensitivity, specificity, diagnostic ratio and summary receiver operating characteristic (SROC) for the diagnosis of fetal hydrops by CVR were 0.86 (95% CI, 0.72-0.93; I = 59.84), 0.90 (95% CI, 0.88-0.93; I = 31.94), 58 (95% CI, 22-149; I = 100%), 0.93 (95% CI, 0.91-0.95).

CONCLUSIONS

The sensitivity and specificity of CVR cut-off value 1.6 for the diagnosis of CLM-induced fetal hydrops were high, no publication bias was observed, and the CVR cut-off value 1.6 is meaningful for the early diagnosis prediction of CLM-induced fetal hydrops.

摘要

目的

采用荟萃分析评估 CVR 截断值为 1.6 用于诊断先天性肺畸形(CLM)所致胎儿水肿的诊断价值。

方法

系统检索 PubMed、Embase、Web of Science、CNKI、VIP 和万方数据库,检索时间截至 2021 年 7 月 30 日,以评估先天性肺气道畸形容积比(CVR)截断值为 1.6 用于诊断胎儿水肿的价值。根据纳入和排除标准,获取符合要求的文献。共检索到 75 篇文章,纳入 12 篇文章进行进一步分析。根据 Quality Assessment for Studies of Diagnostic Accuracy tool(QUADAS-2)标准评估这些研究的质量。采用 Q 检验和异质性 I 检验评估非阈值效应引起的异质性,并使用 Stata 15.0 进行统计分析,以评估 CVR 截断值为 1.6 用于诊断 CLM 所致胎儿水肿的诊断价值。

结果

共纳入 12 项研究。QUADAS-2 表明,偏倚风险相对较低,临床适用性相对较高。对纳入的研究采用随机效应模型进行统计分析。Meta 分析显示,CVR 诊断胎儿水肿的合并敏感性、特异性、诊断比值和汇总受试者工作特征(SROC)为 0.86(95% CI,0.72-0.93;I=59.84),0.90(95% CI,0.88-0.93;I=31.94),58(95% CI,22-149;I=100%),0.93(95% CI,0.91-0.95)。

结论

CVR 截断值 1.6 用于诊断 CLM 所致胎儿水肿的敏感性和特异性较高,未观察到发表偏倚,CVR 截断值 1.6 对 CLM 所致胎儿水肿的早期诊断预测具有意义。

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